Medications for Allergic Rhinitis

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most common side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

There are many types of medications—both over the counter and prescription—that can be used to treat symptoms of allergic rhinitis, and each class of medications works differently in the body.
However, once a definite diagnosis of allergic rhinitis is made, the first-line treatment of choice is nasal corticosteroid spray, as it is has been shown to be the most effective with the fewest side effects. Ask your doctor which medications may offer the best prevention against allergic rhinitis symptoms.

Antihistamines block or reduce the action of histamine, a chemical that is released when the immune system reacts to an allergen. The release of histamine leads to the symptoms of allergic rhinitis.

Possible side effects include:

Drowsiness

Lightheadedness

Blurry vision

Change in ability to think clearly

Dry mouth, nose, or throat

Gastrointestinal upset, stomach pain, or nausea

Increased appetite and weight gain

Thickening of mucus

Increased effects in people with
kidney disease
due to slower removal from the body

Nasal antihistamine sprays are also available, such as
azelastine
(Astelin).

Oral Decongestants
and Antihistamine Combinations

Common names include:

Fexofenadine and pseudoephedrine (Allegra-D)

Acrivastine and pseudoephedrine (Semprex-D)

Azatadine and pseudoephedrine (Trinalin)

Decongestants help to narrow the blood vessels, which results in a clearing of nasal congestion. Antihistamines help stop or reduce the production of histamine, a chemical that is released when the immune system reacts to an allergen.

Possible side effects of the oral decongestant/antihistamine combinations include:

Drowsiness

Cough

Increase in blood pressure

Headache

Nervousness, difficulty sleeping

Nausea

Rapid heart rate

Nasal Corticosteroid Spray

Common names include:

Beclomethasone
(Beconase)

Budesonide nasal
(Rhinocort)

Fluticasone
(Flonase)

Triamcinolone
(Nasacort)

Mometasone
(Nasonex)

Budesonide
(Rhinocort)

Nasal corticosteroids are sprayed or inhaled into the nose to help relieve the stuffy nose and discomfort of allergies.

Possible side effects include:

Burning, dryness, or other irritation inside the nose (mild, lasting only a short time)

Increase in sneezing

Irritation of the throat

Nasal Mast Cell Stabilizer

Common name: Cromolyn sodium (Intal)

Cromolyn is unique in that it is preventative. It changes the body's immunological response to allergens. It is most effective when used before coming into contact with substances that cause allergies or before allergy season. Cromolyn may be used alone or with other medications.

Possible side effects include:

Burning, stinging, or irritation inside of nose

Flushing

Increase in sneezing

Leukotriene Inhibitor

Common name:
Montelukast
(Singulair)

This medication is also used to prevent allergy symptoms. It works by decreasing how many leukotrienes (chemicals) the body creates in response to an allergen.

Possible side effects include:

Flu-like symptoms

Nervousness

Headache and stomach ache

Nausea and vomiting

Nasal congestion

The US Food and Drug Administration (FDA) recommends that this medicine have a label that warns that there may be a link between taking this medicine and having suicidal thoughts. Talk to your doctor if you have any suicidal thoughts. If you are taking Singulair, do not stop right way. Talk to your doctor first.

The following medications are available without a prescription. Many of these are older or first-generation antihistamines. First-generation antihistamines can cause drowsiness. However, both loratadine and cetirizine are nonsedating second-generation antihistamines.

Diphenhydramine
(Benadryl)

Chlorpheniramine (Chlor-Trimeton)

Brompheniramine (Dimetane)

Dexbrompheniramine and pseudoephedrine
(Drixoral)

Clemastine
(Tavist)

Chlorpheniramine and phenylpropanolamine (Triaminic Allergy)

Several second-generation antihistamines are also available over the counter. Second-generation antihistamines are nonsedating.

Loratadine
(Claritin)

Cetirizine hydrochloride
(Zyrtec)

Fexofenadine
(Allegra)

Antihistamines help reduce or block the action of histamine, a chemical that is released when the immune system reacts to an allergen. The release of histamine leads to the symptoms of allergic rhinitis.

Decongestants help to narrow the blood vessels, which results in a clearing of nasal congestion. One possible side effect is an increase in blood pressure.

Nasal Decongestants

Common names include:

Afrin

Neo-Synephrine

Nasal sprays help relieve the stuffy nose and discomfort of allergies.

Possible side effects include:

Burning, stinging, or irritation inside of nose

Flushing

Increase in sneezing

Rebound (increased nasal congestion) if nasal decongestant sprays are used for more than three days

Saline Nasal Spray

Salinex
is a nasal spray that contains a saltwater solution to rinse your nose and help relieve mild congestion, loosen mucus, and prevent crusting. Though it can be useful for relieving symptoms of a stuffy nose and has no side effects, saline cannot prevent allergy symptoms from occurring, as some other allergy treatments can.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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